OIG Work Plan Issues for Facilities

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Avoid OIG Scrutiny By Examining These Key Areas In Your Facility

If you examine your practice’s E/M trend line, does your frequency of reporting high-level E/M codes increase dramatically over the years? If so, you should determine the reasons why, before your MAC begins forcing you to make that determination.A recent OIG study found that physicians increased their billing of higher-level E/M codes across all categories (inpatient, outpatient, etc.) between 2001 and 2010. In fact, the OIG sent CMS a list of 1,700 physicians who were identified as "consistently billing higher-level E/M codes in 2010."The report results were summarized as follows by the OIG in its report, "Coding Trends of Medicare Evaluation and Management Services," which was published on May 9.Inpatient: When it came to hospital visits, the OIG noted that billing the lowest code (99231) decreased 16 percent, whereas billing 99232 increased six percent and 99233 increased by nine percent.Emergency: The shift was even more pronounced among emergency department visits, the report stated. During the study period, physicians decreased how often they billed the four lowest codes (99281-99284), but increased billing the highest code (99285) by a startling 21 percent.Don’t let your facility fall prey to OIG scrutiny. This expert audio conference, presented by Duane C. Abbey, Ph.D., CFP, will go in-depth with FY2008-FY2012 OIG Work Plan issues, so that you’re not exposed in 2013. You’ll see trends that will help with external auditing, so that you can make certain that your facility is addressing OIG and RAC areas of scrutiny. This session will help you:

Learn the OIG Work Plan process.? Uncover how the RAC development and approval of issues works.

Identify OIG trends for issues and their relationship to RAC issue development.

Find out what compliance areas your hospital, facility, and other health care providers must address.

Draw the line from the various OIG reports to audits and studies performed as part of the OIG Work Plan.

Predict what issues the RACs will investigate next.

Event Outline/Agenda:

Review The OIG Work Plan Process

Review The RAC Process

FY2013 OIG Issues

Review FY2008 Through FY2012 Work Plans

Associated RAC Audit Issues

Identification of Action Steps For Health Care Providers

Review of Reports and Compliance Guidance Issued by the OIG for Hospitals, Clinics and Physicians, and other Healthcare Providers

Duane C. Abbey, Ph.D. is a management consultant and president of Abbey & Abbey, Consultants, Inc., which specializes in healthcare consulting and related areas. Duane earned his graduate degrees at the University of Notre Dame and Iowa State University and has more than 20 years of experience as a consultant. He performs various types of financial analysis involving business structuring, organizational development, enrollment and other financially related concerns of organizations....
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